Introduction
To describe a new technique for superficial implantation of the I-Stop TOMS transobturator
sling and present the clinical outcomes on patients treated for mild to moderate urinary
incontinence after radical prostatectomy.
Technical Considerations
We evaluated the four-arm sub urethral sling I-Stop TOMS performed in our institution
between March 2012 and March 2015 using a superficial implantation technique. After
a small incision, the perineal aponeurosis was incised but no muscle dissection was
performed. Inclusion criteria for sling procedure used in the study was mild (1-2
pads/day) to moderate (3-5 pads/day) postprostatectomy incontinence and at least 12
months after radical prostatectomy. Improvement was defined as the patient having
50% reduction in the number of pads and success as patient either not wearing pads
or using one security pad. The primary objective was to evaluate the proportion of
patients achieving continence after the modified sling implantation technique at 12
months after surgery.
Fifty-two patients underwent our new technique and 34 had completed 12 months follow-up.
The procedure was successful for 28 patients (82.4%). There was an improvement in
25 patients (73.5%). Pad use at 12 months had decreased significantly compared with
baseline (mean 0.7 vs 2.2, P < .00001). The complications were rare and the procedure was well tolerated as
shown by median visual analogic scale of 1.5 (interquartile range, 2 to 1).
Conclusion
This novel approach for insertion of the transobturator I-Stop TOMS male sling is
a quick, simple, and well-tolerated procedure with low complication rate, allowing
a significant improvement in postprostatectomy incontinence.
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Article info
Publication history
Published online: December 24, 2015
Accepted:
October 23,
2015
Received:
September 9,
2015
Footnotes
Marc Galiano and Cyrille Guillot-Tantay contributed equally.
Financial Disclosure: Marc Galiano is a consultant to American Medical Systems and CL Medical. The remaining authors declare that they have no relevant financial interests.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
